"The food you eat is making you sick and the agencies that are providing you with guidelines on what to eat are giving dangerous advice with devastating health consequences. You can change that today."

Asthma, atrial fibrillation, and attitude

By Dr. Davis | January 4, 2013

David posted these important observations he made about his own health.

I am a 48 year old male and have been healthy and fit for the majority of my life. I am an avid cyclist and have been so for twenty years now. I have the good fortune of excellent blood pressure and heart rate and my cholesterol and triglycerides are in the healthy range. Until recently, my only notable health challenge has been exercise-induced asthma. I have not been able to ride my bike without an inhaler since I was a kid. Anyone who uses a salbutamol inhaler will be aware that it is a nasty inhalant and can make you agitated and irritable. I have personally hated the thing and wished for years that I could ride without it, but that was never an option. Once or twice I forgot to use it and, within a few hundred meters, I could feel my bronchial passageways closing. I had accepted it as an inevitable reality of my life and condition.

As you can imagine, after reading Wheat Belly, I was in a fervent passion to dump wheat products to see if it would affect my breathing. In my world, the loss of wheat would be a tiny price to pay if I could lose that cursed inhaler once and for all. I am thrilled to announce that for the past two weeks I have been riding without the aid of the salbutamol inhaler and have never been happier in my life. My entire cardiovascular function has changed in some subtle and not-so-subtle ways and I find myself powering up over tough hills and long inclines even better than I did with the inhaler. My recovery rates are faster and more efficient than ever before. This has truly been a miraculous event and I thank Dr. Davis for his work on this subject and for an extraordinary improvement in my health and my life.

But this is not the end of the story. In May of 2012, while working on my farm, I had my first diagnosed event of atrial fibrillation. I had a neighbor rush me to the hospital where it was officially diagnosed. I believe I had a couple of previous A. fib. events that I had passed off as anxiety attacks but in fact they were A. fibs. I learned that it was also a condition that has plagued both of my parents over the years and I was in the high risk category to suffer from it as I got older. I underwent a subsequent battery of tests under the supervision of a cardiologist and was informed that, although my heart is healthy and strong and all of my vitals are excellent, I am doomed to suffer from occasional bouts of A. fib. I have been prescribed ‘event’ medication to take when the arrhythmia strikes. I was also informed that, although rarely fatal, I am at increased risk for a stroke and no amount of exercise or life management will eliminate this condition. I have had 7 A. fib. episodes since the first one in the spring. Needless to say, I am less than happy about this development.

I do not smoke, take drugs, eat poorly or drink coffee. I am a very moderate drinker, although I am a passionate lover of fine red wines. I drink them often but very rarely to excess. So when my cardiologist suggested that I would have to give them up, I was very, very disappointed. On the other hand, A. fib. episodes are nasty beasts and I would be prepared to give up wine (albeit reluctantly) if it meant I could avoid the heart distress.

So, in the fall of this year, I cut back dramatically on my wine intake, limiting myself to only a very occasional glass. It is a fact that 5 of the 7 recent A-fib episodes involved some amount of alcohol (wine or beer). In my case, all of my A. fib. episodes have been preceded by a warning of sorts. I experience an upper chest (gastrointestinal) anxiety or nervousness followed by a couple of heart flutters, which then gives way to a full-fledged attack. The degree of the severity will fluctuate from episode to episode, but the warning signs are always pretty consistent. Notably, there have also been numerous occasions when that upper G.I. nervousness has not resulted in an A. fib. attack, but itself is an unsettling and uncomfortable condition. I have struggled for months to get to the root of this problem without success. So I was astonished to discover that within two days of dropping wheat gluten, my upper G.I. discomfort vanished like magic and I have not had an A. fib. episode since. Over Christmas, I freely indulged in wine without the slightest tremor. I even drank enough on two occasions to require a taxi or designated driver (not drunk, just delightfully tipsy).

I met with my cardiologist and with great excitement told her my story. She simply stared blankly at me and then proceeded to tell me that I had no idea what I was talking about. She is fully prepared to tell me that wine has a direct link but is not willing to accept the possibility that wheat gluten could also be a trigger. In the same breath she also explained that we do not definitively know the trigger for A. fib. So in one breath she will admit it can be caused by the ingestion of a substance and in the other she claims its cause is unknown. Then she proceeded to prescribe a new course of medication. Hypocrisy!! I was furious with her and do not expect to return to her for further consultation. If she cannot show herself to be better than a butcher or drug peddler, then I will have to find a more creative physician.

On the other hand, I accept that there may be far more to this than simple dietary changes but I cannot argue with the outcome. I am further convinced that there is a causal connection, because when I began to review some if the episodes, they almost all had a couple of things in common: alcohol and gluten. The most recent attack involved a bottle of wine and a loaf of sour dough bread shared with a colleague. Another involved wheat beer and yet another involved a family meal with wine, turkey stuffing and pastries. When these gluten items are eliminated, the A. fib. does not occur. I don’t think this is an irrelevant fact and will be watching closely in the months ahead to see if the rule remains true. If I get to the one year mark without an episode I will be looking for a cardiologist who is willing to study this more carefully to see if there is relief for other A. fib. sufferers in the gluten free regimen.

Notwithstanding the unwillingness of traditional medical professionals to accept a causal link between A. fib. and gluten or asthma and gluten, I am thrilled and renewed with excitement about the prospects of the next couple of decades of my life without inhalants and heart rate mediators. Dr. Davis, I thank you for your thoughtful and carefully researched work and your passion for the cause of health through moderated diet.

David experienced asthma with exercise likely due to the allergic effects of omega-gliadin from wheat on lungs and airways. Use all the inhalers, antihistamines, or prednisone in the world, but real relief can ONLY come through removing the provocative factor–wheat.

The atrial fibrillation is another story. It is not clear to me why, as with David, I’ve seen many people experience either a marked reduction in the frequency and/or severity of atrial fibrillation episodes, occasionally complete cessation of the rhythm. Could it be the inflammation-reducing effects of eliminating the gliadin protein (responsible for two way increased small intestinal permeability)? Could it be due to eliminating the excessive high blood glucose/glycation of the amylopectin A of wheat? Or perhaps some other arrhythmogenic (abnormal rhythm-generating) component of modern wheat?

I don’t presently have an answer. But the potential effects of wheat elimination on atrial fibrillation would be consistent with all the other observations we are making: There is no organ system that is not adversely affected by consumption of modern wheat.

David’s experience is also an example of how modern healthcare has a drug for virtually every wheat-related condition: inhalers for asthma, beta blockers and rhythm-suppressing agents for atrial fibrillation, acid blocking drugs for acid reflux, anti-inflammatory medication for joint pain, blood pressure medication for hypertension, cholesterol drugs for “high cholesterol,” antipsychotic drugs for the paranoia of schizophrenia, and so on. Aside from tending to victims of motor vehicle accidents and other traumatic injuries, to a great extent modern healthcare is a healthcare system set up to treat the consequences of wheat consumption.

Comments & Feedback...

I picked up an old diary and opened it at random, I could hardly recognise the person in the pages, her weight was sprialing out of control, she was suffering from skin complaints and insomnia and was afraid she had early onset alzheimers.
Six month’s later, after a ‘wheat less’ diet (its too hard to completely cut it out) and I’m a new woman.
I don’t have to think about my weight, each month another kilo has gone, with no effort, I have a new sensation of fullness after eating a moderately sized meal. During the day I don’t need ‘lunch’ as such, An apple and a handful of nuts fills me up. I have found a non-GM baking mix and will cautiously be baking now and then to enjoy some ‘old fashioned’ bread. Thank you Dr Davis for alerting us to this food industry scam.

I definitely notice heart affects when I get glutened. After wearing a heart monitor after one bad episode, neither caffeine or other typical ’cause’ set it off. I was not interested in testing the gluten…. just not worth it. In the urgent care, I mentioned getting glutened and wondered if that might be the cause. I was brushed off completely.

Oh my goodness! This post has gone straight to my heart, literally.
A year ago last September I was 48 and went swimming for the first time in a long time. It was also the first exercise for a few weeks because I’d broken my arm and the cast had just come off. As I got out of the pool I was aware of a terrible feeling of heaviness in my legs. I could hardly walk. I rested a bit, showered and left to drive home. I’d only gone a few hundred yards when I was hit with the most frightening heart arrhythmia I could imagine. I got myself home somehow and we decided to wait until morning. That was the start of a scary few months and resulted in March of 2011 with a diagnosis of A.Fib. I was horrified. I too had experienced these events before but not as harshly and not long enough to be caught on ECG and I’d also put them down to stress and panic attacks.

I was offered beta blockers but I didn’t want them and the consultant I finally saw said there wasn’t much point for me. I also managed to stop them putting me on blood thinning medication as my heart and vital signs were good, and although my cholesterol was high my HDL was good. I was told this was something I would have to live with. It ruined my self-belief. How could I live not knowing when the next event would happen. I stopped exercising, I worried incessantly and my doctor just nagged me about statins and told me there was nothing I could do to stop these things.

I had been seeing a nutritionist about my digestive disorders and she came to my rescue. She had come across this before and sent me for a proper vitamin and mineral screening and just as she suspected to be the case, it turned out that my magnesium was low at the cellular level, as was my vitamin D. Over the time since then we’ve worked hard to bring my magnesium levels up and optimise my vitamin D. We’ve done well, tests before Christmas showed both in the normal range, but I’m aiming for higher. I take a magnesium/calcium citrate supplement, I apply magnesium oil to my skin night and morning and I occasional have a bath in magnesium salts.

In amongst all that I also gave up wheat at her suggestion and then I found this Wheat Belly phenomenon. At first I dabbled, but now I’m much more serious. I’ve swapped dairy for goat’s milk and cheese and that seems good for me too. But (touching everything wood possible) I’ve not had an A.Fib attack since March 2012. I hadn’t even considered wheat for this. My Dad suffers AF and I thought I was doomed. Perhaps I am, long term, but for now if giving up wheat and boosting my minerals and vitamins helps, I’m on it! If only I could find a way to optimise my thyroid then I’m sure some weight would come off too. That is the next goal, optimise thyroid and adrenal glands.

It’s horrible how little our GP’s seem to know about the most important things. I was devastated by the AF diagnosis. Probably because Dad had just had major open heart surgery.

For all other AF sufferers out there, let’s see if we can beat this beast! Magnesium and wheat free. The new mantra.

Dr Davis, if anyone can start looking into this connection then it’s you, as your whole career must have been dealing with this sort of thing.

I have been an asthmatic for my entire life. Over a year ago I went grain free- and bucked 4 asthma meds as a result. While I have yet to be 100% inhaler free, I’d say 2 a year compared to 1 a month is a HUGE improvement!

Re: magnesium deficiency, grains in general bind to magnesium and prevent its absorption. Alcohol tends to deplete magnesium. And if someone is on acid blockers for GI distress, those, too, prevent magnesium absorption.

Yes, I was on acid inhibitors for acid reflux (another mistake? Looks now like I have low stomach acid not high!) for quite some time, then I broke my arm which caused a huge spike in stress because I was unable to run my business, another depleting action. And of course I have suffered with IBS for years and that affects absorption too. Recipe for a problem.

You may be interested in a couple of books (in case you haven’t already heard of them). The Meat Fix: How a Lifetime of Healthy Eating Nearly Killed Me by John Nicholson, who suffered from severe IBS for almost 20 years, and Fast Tract Digestion by Norm Robillard, a microbiologist who links GERD with IBS.

A lot of people say that milk gives them GERD; fruit does it to me. I’ve never had IBS, but I’ve heard fiber makes it *worse.*

Dr Davis, as you said, “There is no organ system that is not adversely affected by consumption of modern wheat.”
Soon we will be able to have Frankenfish to go with our Frankenwheat. The FDA is a step closer to approving a genetically engineered salmon for human consumption. The FDA said the fish “doesn’t appear likely to pose a threat to the environment or to humans who eat it.” If it gets a final go-ahead, it would be the first food from an animal whose genome has been altered to be approved by the FDA. There are concerns the FDA will not require the genetically modified salmon to be labeled as genetically modified either, if/when introduced into our food supply. The FDA said it would take comments from the public on its report for 60 days before making a final decision on approval. Those who are against genetically modified food, feel free to contact the FDA and weigh in. Reuters has the full article at this link:http://www.reuters.com/article/2012/12/21/us-usa-fish-gmo-idUSBRE8BK16O20121221

Dr. Davis: Could it be the inflammation-reducing effects of eliminating the gliadin protein (responsible for two way increased small intestinal permeability)?

Wheat-caused shortages of two substances lead my list of suspects, adenosine and choline. Gluten-induced intestinal permeability dumps the lumen into the bloodstream before digestion can produce adequate adenosine. Insufficient adenosine in the liver curtails its production of choline.

Adenosine is the body’s primary queller of inflammation. Choline is the nervous system’s means of stifling signal transmission. The brain and heart sinus transmit impulses to heart muscles. Choline is needed to quell the impulses after the proper duration. Choline shortage causes transduction nerves to raise the impulse voltage threshold too close to the impulse apex voltage. Adenosine shortage-induced inflammation makes heart muscles unable to discern the “pump” signal from the “rest” signal.

My doctor prescribed a beta blocker to treat my WPW arrhythmia. I ingested one pill, felt the effects, and placed the remainder of the pills in a safe place …..to be used only in dire emergency. Luckily I found out about wheat elimination before an emergency arose.

Two things:
– There is no generalized deficiency in neurotransmitters such as adenosine and choline, as their production and use is highly compartmentalized. I’d rather suspect either something inflammatory or maybe a direct action of Triticum proteins.
– You control your WPW through diet, seriously? What were your symptoms before wheat restriction and what are they now?
WPW … dude, c’mon, seriously, I’m the critical die-hard scientist, wheat can’t cause everything – but some days it seems like it just *can*.

I admit to not being an expert. Perhaps I should have referred to the liver’s production of cholinesterase instead of choline.

Adenosine is only provisionally an essential nutrient. It can be re-formed cellularly, but systemic shortages of choline produce cellular shortages of adenosine. Adenosine performs two major functions. It increases metabolic rate, and it quells inflammation. I am not aware of any roll adenosine might play as a neurotransmitter. Adenosine is supposed to be an abundant product of digestion. The body teems with adenosine so the medical establishment assumes everyone’s supply to be adequate without ever testing this theory or establishing an RDA.

When we eat the liver releases bile acid into the stomach. The bile acid dissolves fat, and triggers digestive enzymes like pepsin which break apart meat proteins. When we consume complex carb proteins like wheat gluten they are not digested in the stomach. They are digested starting in the small intestine. DPPIV is the primary digestive enzyme which slowly deamidates wheat gluten. The small intestine’s immune system starts viewing gluten as an antigen, and releases zonulin. Zonulin arrests digestion. It makes the small intestine walls porous. It dumps the lumen into the bloodstream before DPPIV can break these proteins into constituents like adenosine.

When digestion is complete the liver produces cholinesterase. In the lower intestine cholinesterase reabsorbs unused bile acid for storage in the gall bladder. The next part is poorly documented. The liver monitors when to switch from bile production to cholinesterase production by monitoring its own metabolic rate. The metabolic rates of all cells are enhanced by adenosine, and therefore by complete digestion. So the liver keys its switch-over from bile production to cholinesterase production in large part, by monitoring adenosine supply.

Acetylcholine is the nervous system’s main neurotransmitter. Besides its roll as a bile reabsorption agent cholinesterase is also the base chemical of acetylcholinesterase, the nervous system’s main squelcher of nerve impulses. Shortages of cholinesterase would leave acetylcholine-facilitated heartbeat impulses with very little to check them. The threshold for impulse would raise, leaving little voltage distinction between pulse impulses and rest.

As I understand it my WPW arrhythmia takes a different pathway from the subject arrhythmia. In hindsight I blame my WPW on Graves disease. Graves disease is sometimes accompanied by WPW arrhythmia, as well as other symptoms I was displaying. WPW usually results from a short circuit running to the heart sinus. It shortens the period between “lub” and “dub”. WPW doesn’t have its roots in signal gain, but rather in electrolyte deposits. All autoimmune diseases begin with the kind of zonulin permeability which wheat and sugar create.

http://en.wikipedia.org/wiki/Choline
————————————————————————–
Choline must be consumed through the diet for the body to remain healthy.[6] It is used in the synthesis of the constructional components in the body’s cell membranes. Despite the perceived benefits of choline, dietary recommendations have discouraged people from eating certain high-choline foods, such as egg and fatty meats. The 2005 National Health and Nutrition Examination Survey stated that only 2% of postmenopausal women consume the recommended intake for choline.[7]
————————————————————————–

Because of enhanced lutein and zeaxanthin I would not recommend commercial hen eggs to anyone. But meat is a great source of choline.

Adenosine is not neurotransmitter, it is neuromodulator. And it is involved in decreasing inflammation and regulation of immune cells differentiation. Hydration protocol of Dr Batmanghelidj is about avoiding caffeine( which blocks adenosine) and results somehow in significant improvement in inflammatory diseases sometimes…

I dont know about adenosine involvement in digestions. But it is a product of ATP utilization.

I fear we can only speculate, as this area has not been formally explored at all. But your ideas may be an avenue worth pursuing. In particular, a lack of adenosine, because it has effects on AV node and other cardiac conduction tissue, is an especially interesting notion.

I went gluten free because,awhile ago (1 year or more) I heard beening gluten free was good for anyone:and I got to 388lbs I desided it was time to do something about it.I have been wheat free 2 months now at 345lbs.

For those not tempted to follow the link, that blog author is aware of WB, hasn’t read it (but plans to) and seems to be hanging out in hope that she won’t have to give up wheat. Perhaps wrotek can keep an eye on that blog for developments.

There is steroidal diabetes through cortisol, yes, but the diabetes we are dealing with mostly is type 2 diabetes. It does indeed have to do something with glucose homeostasis, but it is not the cause (or even sole effector) of diabetes in >99% of cases.

The “blood sugar drop” theory sucks, because you have insulin and glucagon for short-termin regulation and some hypothalamic mechanisms at work. It has been dismissed and found to be wrong about one trillion times, yet the layman theory of blood sugar drops is nonsense.

Type 1 is an autoimmune disease of unknown origin. Of course, Dr. Davis rightfully suspects that wheat is a main inductor of the abnormal immune response against insulin-producing cells (why the hell would your body attack your own tissues, for god’s sake?), but the final cause is not established. It could also be that there are multiple causes.

Type 2 is your “old and/or fat people” diabetes. We all know the best treatment already – grain-free low-carb. Of course, in the long run, diabetes type 2 will kill off your insulin-producing tissue cell by cell, so an end-stage type 2 might appear clinically as a type 1. But that is rather uncommon, even when treated conventionally.

As I said above, all autoimmune diseases result from the kind of intestinal permeability induced by wheat. All autoimmune diseases happen when undigested peptides attack tissue from the bloodstream. The immune system responds by destroying and removing the effected tissue. In the case of organs the peptide attack usually takes the form of food exorphins plugging into transduction processes. Wheat can induce this attack in the pancreas with exorphin peptides A5 and B5. As the term “exorphin” implies, A5 and B5 mimic endorphin.

The pancreas releases insulin in response to two blood chemicals, glucose and endorphin. Most people know about the glucose-insulin response. They don’t know about the endorphin-insulin response.

The pancreas monitors endorphin for the fight-or-flight response. The body adrenal glands release a flood of adrenalin for fight-or-flight. This flood causes muscles to catabolize food at such a fast rate that they can even ingest themselves. High catabolism causes muscles to release endorphin. It dulls the pain associated with catabolism. The pancreas senses the endorphin, and releases insulin. The insulin slows catabolism so that muscles do not destroy themselves.

When exorphins like wheat A5 and B5 plug into pancreas beta cells, the pancreas perceives fight-or-flight catabolism, and releases insulin. So in the absence of any immune response wheat can cause reactive hypoglycemia. Many people’s immune systems interpret this exorphin activity for what it is, an antigen attack. They create antibodies, and remove the affected tissue. Unfortunately in this case, the tissue is the beta cells in the pancreas’s Islets of Langerhans. The result is type 1 diabetes. The main symptoms of type 1 diabetes are loss of insulin and elevation of blood glucose.

Can other exorphins cause type 1 diabetes? Yes, most notably peptides from milk casein. But these peptides must be placed in the bloodstream by intestinal permeability, the kind associated with wheat ingestion. I am convinced, and some research indicates, that beta cells are transient. The body is capable of restoring insulin function to a great extent. But first you must eliminate the exorphin attack.

I had been gluten-free (and asthma & arrhythmia free) for 4 months when Christmas rolled around and I started getting xmas cookies as gifts. Most of the time I regifted these, but when I received a box of Lebkuchen from Germany, I couldn’t resist eating just one. I had no adverse reaction – not even bloating or diarrhea (which had been the norm for me after every meal, before I cut out wheat). So I tried a little experiment – I had two slices of bread (sourdough fresh from the bakery). Within 10 minutes, I was wheezing and I had a headache. The next day, I tried some of the mac & cheese I made for my son and I became bloated and felt nauseous. So I waited a couple more days & tried another Lebkuchen (mind you, the first ingredient listed is ” weizen mehl” – wheat flour), and again, no reaction. So a couple of days after that, I ate two pieces of whole grain wheat toast (organic, sweetened with fruit juice) and I had some of the worst heart palpitations, dizziness, shortness of breath I’ve ever had. It really scared me and left me debilitated for most of the rest of the day.
So I have two questions – is there any evidence that European wheat is less harmful than American wheat? And, are my heart symptoms (which my doctor had previously chalked up to panic attacks) related to wheat consumption?
One final note – my computer is down so I’m typing this on my smart phone…I apologize for any typos or incorrect auto-corrects I may not have caught!

Evidence, no. Except that there are indeed variations in the strains (“cultivars”) in different areas that can account in variation in effects.

Also, European farmers to a modest degree are more likely to replant their seed, passing on older strains via the seed they harvest from the previous year’s crop, rather than purchase their seed yearly from an agribusiness supplier.

Hey, it’s Kate with the great reduction in Cholesterol etc!! Front page!

I got an email from my son this morning. He and his family have recently gone gluten free and he’s having a hard time with his daughter, my grand daughter’s literal loss over the “fun foods” or probably better put “the bad sweet foods”. Birthday parties are real tuff for her.
Now I have to say I am so proud of my kids going gluten free and from reading your book and listening to your audio!! I try to encourage them as much as I can but I do get how tuff it is for an 8 year old to make this change because of peer pressure and more.
I told my son, Ed, I was going to blog about this thinking I might get some good advice for he and his wife as to idea’s on how to deal with this.
They have explained to her the value of what they’re doing but shoot.. When she breaks into tears and says “I don’t want to be gluten free anymore”.. what do you do?
One main reason for doing this is because Samantha has had asthma and they’re hoping this will resolve this as time goes on.
Ok, It’s easier for me to deal with talking to the adults about this.. what does a mom and dad say to their 8 year old daughter as they make this transition? I might add I do realized you, Dr. D. are NOT a psychologist.. so perhaps it’ll be other bloggers that will be able to help us with this!!

This is the reason I provide the recipes, Kate, so that parents can make muffins, cookies, brownies, and other foods that are nearly indistinguishable from their wheat- and sugar-based counterparts. Involve the kids in the process and let them enjoy the end products.

It is also clear that this is NOT about the loss of “fun foods,” but the child’s way of struggling with her addiction to the opiate in wheat, gliadin. Recognize this for what it is: It is NOT a call for help; it is the expression of a perverse addiction, the one the food industry hopes to sustain in order to make your granddaughter a lifelong customer of their corrupt products.

My A-fib started when I was one year completely wheat free. I don’t drink alcohol, so I have no explanation. I will be having surgery to correct this issue, since I hate the metoprolol needed to control it. When I eliminated wheat, I also cured my eczema. Metoprolol has brought it back…with a vengeance. I can’t stand it. After doing everything “right “, I’d love to know what caused the A-fib episodes to occur.

Well, I hope I didn’t give the impression that wheat causes all atrial fibrillation–it does NOT. There are many other causes.

However, one probable cause is glycation (glucose-modification of proteins) of the heart’s conduction system; once it occurs (as it does every time blood sugar ranges above normal), glycation occurs and is irreversible. So, in addition to causes of atrial fibrillation outside of wheat, there are also irreversible changes that likely developed in your wheat-consuming years.

I’m was diagnosed A-fib after a mini stroke and tests that revealed an enlargement of the atrial chambers with a constant fibrillation that varies in intensity. Before meds I felt anxious frequently.
My M.D. has me on Wafarin and Locartin for hypertension. Over a year prior to this I had stopped eating grains, except for small amounts of rice. Way back in 1994, a blood test showed an antibody reaction to gliadin as 191 with suggested consumption every 4 days. No idea what gliadin meant. Big allergies to grasses since early childhood and low blood sugar black outs in my thirties. Now 75, I assume my atrial
chambers aren’t going to go back to normal size but I would love to be medicine free. Is that a reasonable
desire?
Katherine